Application Form

Shree Mahesh Heritage, Rishikesh, India

Your Personal Details

Only for official Record. Will NOT be shared with your anyone.

First name
Last Name
Date Of Birth
E-mail Id
Re-Enter e-mail Id
Gender
Your Current Occupation
Website (if any)
Height
Weight(Kg)
Country
Your Phone Number *(with state/country code)

Select Your Program And Date ,Which you Are Applying For

Meditation Teacher Training
Meditation Retreats
Meditation for Beginners
Life Healing
Ayurveda program
Customized program
Yoga/meditation Related Details
Please provide your Yoga related experience or trainings you had before
What do you expect to gain from this program?
How you came to know about us?

Emergency Contact :

Name
Phone No
Your Relationship with contact :
Email (of emergency contact) :

Health Information :

The following questions are here to help us provide each student with the necessary means to make the selected program experience enjoyable for all. The answers to these questions will be kept in strict confidence, and may be discussed with the applicant to make sure that the it is the right choice for them.

Are you currently taking medication for any physical or psychological condition?
YesNo
Do you have any chronic physical limitations or disabilities?
YesNo
Do you have a history of psychological or emotional illnesses, or issues?
YesNo
Do you have a communicable disease?
YesNo
Have you had a serious illness or major surgery within the last five years?
YesNo
Are you currently pregnant or trying to become pregnant?
YesNo
If you answered YES to any of the above questions, please provide us with more relevant details as it would pertain to the teacher training program. As well, please describe if there is anything else you feel we should know with regards to your participation in the program here: